Don’t sequester health care’s future

4/6/2013

BY JEFFREY GOLD

Gold

Every day, physicians and scientists at the nation’s medical schools and teaching hospitals, including the University of Toledo Medical Center, are part of miraculous stories: life-saving cancer care, and rapid treatment of patients who are in the midst of a stroke or were injured in auto accidents or by violent trauma. Such stories grab headlines and appear on billboards.

In addition to providing state-of-the-art medical care, UTMC is teaching the next generation of physicians. No matter where they train, they will know how to provide a high level of care when they start practicing in local communities.

We conduct research to develop groundbreaking cures, treatments, and important public-health tools such as flu vaccines. And because vaccines may not be 100 percent effective, when you get the flu — or a virus for which there is no vaccine — we care for you, your family, and your neighbors, whether or not you have health insurance.

But because of automatic, pervasive funding cuts in federal spending — the process called sequestration — the mission of UTMC and all other academic health centers is in jeopardy. Sequestration is a big concern for medical schools and teaching hospitals. It threatens the work we do in education, clinical care, and research.

These institutions conduct about half of all external research funded by the National Institutes of Health. At UT, research sponsored by NIH has provided, on average, more than $20 million a year for the past three years.

For NIH, sequestration means a $1.5 billion budget cut in the first year alone. The institutes’ director, Francis Collins, calls this prospect a “profound and devastating” blow at a time of unprecedented scientific opportunity.

Breakthrough discoveries that might save lives or improve the quality of life for all Americans will not occur. Research that gets put on hold, even for just a few weeks, may take years to regain its promise. This cut in NIH funding could result in the loss of thousands of jobs across Ohio, including at UT.

Sequestration threatens Medicare payments to hospitals and physicians, at a time when these providers already face a broad range of cuts in reimbursement. And cuts to provider payments are cuts to patient care: Further funding reductions, when Medicare already fails to cover the cost of care, could strain the limited resources of teaching hospitals. These resources help support trauma centers, inpatient psychiatric units, and sickle cell clinics.

Today, teaching hospitals are pressed to maintain funding for unique, mission-related services that are not available elsewhere in their communities. Teaching hospitals represent only 6 percent of all U.S. hospitals, but they operate 80 percent of Level 1 trauma centers.

Teaching hospitals provide not only the physical infrastructure but also the many physicians and other health professionals who are needed to care for a patient with multiple gunshot wounds or a victim of horrible trauma. They must maintain 24/7 access to vascular surgeons, orthopedic specialists, neurosurgeons, and other highly skilled professionals who remain on call — and get paid — even if they are never needed. At UTMC, the annual impact will be in the millions of dollars.

In addition to jeopardizing services, sequester cuts could result in the loss of nearly 34,000 jobs at academic medical centers across the country. These include workers who are directly employed in the health-care sector, as well as others whose jobs are supported by purchases by care organizations and their employees.

At UTMC, the loss of Medicare funds because of the sequester could force us to eliminate 50 full-time jobs. These good-paying jobs support Toledo families.

Congress and President Obama must work together to solve the nation’s budget crisis. For some Toledo area citizens, it could be a matter of life or death.

Jeffrey Gold, M.D., is chancellor and executive vice president for health affairs of the University of Toledo.

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